Provider Demographics
NPI:1679231054
Name:GONZALEZ DOLLAR, JUDITH NOELIA (APRN)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:NOELIA
Last Name:GONZALEZ DOLLAR
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22672 SW 105TH AVE
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33190-1457
Mailing Address - Country:US
Mailing Address - Phone:305-333-9068
Mailing Address - Fax:
Practice Address - Street 1:22672 SW 105TH AVE
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33190-1457
Practice Address - Country:US
Practice Address - Phone:305-333-9068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-02
Last Update Date:2023-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11016793363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care